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813-780-0020 City of Zephyrhills Permit Application Building Department Fax-813-780-0021 Date Received Owner Phone Number Owner Phone Number I Owner Phone Number I Owner's Name Owner's Address Fee Simple Titleholder NamJ L-/ifj6tetlf Fee Simple Titleholder Address 112foCJ3 L-AKE- 1~8S-J. d- (~ ~y I ?II LJ-b :53S0l:{ SUI T IS- J. 5 I LOT # I PARCElID#loc?- (;l.ft,--'J( -OOGO - COc-OO'-O::)lO ..........,,(' (OBTAINED FROM PROPERTY TAX NOTICE) ~ SIGN D MOVE D DEMOLISH o~, R 1 VF.J2VIW rL- JOB ADDRESS WORK PROPOSED NEW CONSTR INSTALL SFR BLOCK I ~ D CJ ADD/AL T REPAIR COMM FRAME D D OTHER I STEEL D SUBDIVISION D D D D B PROPOSED USE D TYPE OF CONSTRUCTION D DESCRIPTION OF WORK I \J ( 1oN. \ \ BUILDING SIZE I ~S-O i) J SQ FOOTAGE I HEIGHT Lt d ...1........."....111.......,1...,1.....111..........1,...11,........."............,.......11,...,11,..........,11..........11,.,111111111.,.,1. 1$ ,~../:1x) ( (JQ 1$ 1$ 1$ D GAS D FINISHED FLOOR ELEVATIONS I OTHER I ROOFING I I I I CJ I AMP SERVICE CJ PROGRESS ENERGY D W.R.E.C. BUILDING VALUATION OF TOTAL CONSTRUCTION ELECTRICAL PLUMBING MECHANICAL VALUATION OF MECHANICAL INSTALLATION SPECIALTY D FLOOD ZONE AREA OTHER DYES DNO I I . . . I . . . . I I I . . . I , I I . I I . I . I ~ . . . . . . . . I I I . . . . I I I . . . I . I . . . . I I I . I I . . . . . . I I I I . . . I . . . I I . I . . . . . I I I I I . . . I I I . I . . . . . . . I . I I I I . I I I . . . I I . I I I I I I . . I I . . I I I . . I I I I I BUILDER SIGNATURE COMPANY I A'Z. 1 z... REGISTERED I (~ N MECHANICAL SIGNATURE CoN)!:. &J. I IAJ6 I I ."'1\ I A'E CU"","' r <'l.l' N ~ 5L 5:>v License # lea? 057_87 I I I I I I I I I FEE CURRENT Y/N ELECTRICIAN SIGNATURE .j3S48 COMPANY I REGISTERED Y / N Address License # PLUMBER SIGNATURE COMPANY REGISTERED Y I N FEE CURRENT Y/N Address License # COMPANY REGISTERED Y / N FEE CURRENT Y/N Address License # COMPANY REGISTERED Y / N FEE CURRENT Y/N OTHER SIGNATURE Address License # 111"'111111111 '1111111111'111111111""'11111111111111'1111111,,1111IIIII"I,Iftlllll,"IIIIIIIIIIIIIIIIII"111111111111111111111111"11111111'11 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. SIGN PERMIT Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for all NEW construction. I~II~IIIIIIIIIIIII..III.IIIIIII.I~IIIIIIIIIIIIIIIIIIIIII.IIIIIIII.IIIIIIIIIII.II~IIIII.IIIIIII..IIIIIIIII~IIIIIIIII.~IIIIIIIIIIIIIIIIIIII~IIIIIIII Directions: Fill out application completely. Owner & Contractor sign back of application, nDtarized If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000) Agent (for the contractor) or Power of AttDrney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades AlC Fences (PloUSurvey/Footage) Driveways-Not over Counter If on public roadways..needs ROW